Persistence and Compliance Among U.S. Patients Receiving Pazopanib or Sunitinib as First-Line Therapy for Advanced Renal Cell Carcinoma: A Retrospective Claims Analysis

Byfield, Stacey A. DaCosta; McPheeters, Jeffrey; Burton, Tanya; Nagar, Saurabh; Hackshaw, Michelle D.

doi:10.18553/jmcp.2015.21.6.515

Cited by 17 publications

(25 citation statements)

References 34 publications

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“…Of the eight real world studies that included treatment-naive patients only, all included some PFS or OS analysis ( 7 – 9 , 11 – 13 , 20 , 21 ), but only two reported mPFS suitable for comparison. The mPFS in these two studies was similar to that reported in the phase III study and EAP, at 8.9 months ( 12 ) and 9 months ( 8 ).…”

Section: Resultsmentioning

confidence: 99%

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Sunitinib in Metastatic Renal Cell Carcinoma: A Systematic Review of UK Real World Data

et al. 2015

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BackgroundReal world data (RWD) are increasingly used to inform drug reimbursement decisions, but it is unclear how well outcomes from real world studies compare to those of clinical trials. This systematic review seeks to compare outcomes for sunitinib in routine UK clinical practice with the sunitinib registrational and expanded-access program clinical trials.MethodSystematic review of the real world published literature was undertaken. UK observational studies recording first- or second-line sunitinib efficacy were included. A qualitative summary of the results and comparison to the controlled clinical trials was conducted. Fifteen real world studies were included, 14 of which were only available as posters/presentations.ResultsReal world study reporting quality was generally low, making comparisons with the clinical trials difficult. Practice relating to starting dose, dose modification, timing of therapy initiation, and other factors varied between centers. Median progression-free survival and adverse events were generally comparable to the clinical trial outcomes, but overall survival was not.ConclusionThere are few published data on sunitinib use in UK clinical practice. Studies are characterized by lack of peer reviewed publication and heterogeneity in design, reporting, and analysis. For use of RWD in the reimbursement setting, data collection and reporting will need to improve.HighlightsThere are few published data on sunitinib use in UK clinical practice.Studies are characterized by lack of peer reviewed publication and heterogeneity in design, reporting, and analysis.Practice varies considerably between different UK centers.Median progression-free survival and adverse events are generally comparable to the clinical trial outcomes, but overall survival is not.For use of real world data in the reimbursement setting, data collection and reporting will need to improve.

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Section: Resultsmentioning

confidence: 99%

“…The mPFS in these two studies was similar to that reported in the phase III study and EAP, at 8.9 months ( 12 ) and 9 months ( 8 ). Seven studies reported mOS suitable for comparison, which varied widely, ranging from 10 months ( 21 ) to 23 months ( 20 ).…”

Section: Resultsmentioning

confidence: 99%

Sunitinib in Metastatic Renal Cell Carcinoma: A Systematic Review of UK Real World Data

et al. 2015

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“…In total, 84 matched pairs were identified from 446 patients receiving pazopanib (n = 97) and sunitinib (n = 349). This analysis demonstrated a similar persistence and compliance with pazopanib and sunitinib during the first 6 months of treatment [DaCosta Byfield et al 2015]. Similarly, another retrospective, observational study in the USA using the Truven Health MarketScan databases examined pazopanib persistence and adherence in treatment-naïve patients (n = 62) and previously treated patients (n = 81) [Hackshaw et al 2014].…”

Section: Persistence and Compliancementioning

confidence: 59%

“…In two studies from the USA, these have been evaluated using information from medical claims databases. A retrospective claims analysis of two databases (Optum Research Database and Impact National Benchmark Database) compared the real-world persistence and compliance of patients with mRCC receiving pazopanib with those receiving sunitinib [DaCosta Byfield et al 2015]. Adults with more than two RCC diagnoses and evidence of first-line therapy with at least one pharmacy claim for pazopanib or sunitinib (October 2009-July 2012) were eligible for inclusion.…”

Section: Persistence and Compliancementioning

confidence: 99%

Pazopanib in the treatment of advanced renal cell carcinoma

Cella

Beaumont

2015

Therapeutic Advances in Urology

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Pazopanib is an orally available multitargeted tyrosine kinase inhibitor (a class of targeted therapies) that inhibits tumor angiogenesis and cell proliferation. The safety and efficacy of pazopanib (noninferior to sunitinib for progression-free survival) in patients with advanced or metastatic renal cell carcinoma (mRCC) have been demonstrated in several clinical trials. However, in addition to therapeutic efficacy, treatment choices should also take into account health-related quality of life (HRQoL) aspects of cancer therapy. Here, we summarize the HRQoL findings related to pazopanib use, based on patient-reported outcome measures; pazopanib has been shown to be superior to sunitinib on several HRQoL domains (including patient preference). A further consideration for treatment choice is how well the findings from clinical trials correlate with evidence from general clinical practice. This review therefore includes descriptions of real-world experience of pazopanib use in the treatment of patients with mRCC, following its approval by medical regulatory authorities in a number of countries. Naturalistic observational studies demonstrate that the efficacy of pazopanib in patients with mRCC is consistent with clinical trial findings. Similarly, consistent results were observed for the safety profile of pazopanib between observational studies and clinical trials, with most treatment-associated adverse events being mild to moderate in severity, and manageable.

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“…Search results and quality evaluation Figure 1 shows the study selection process. An eventual 14 studies involving 12,985 patients (pazopanib, 3047; sunitinib, 9938) were selected for this meta-analysis [7][8][9][13][14][15][16][17][18][19][20][21][22][23]. Three studies were RCTs (two studies stemmed from the same RCT with different aspects of results: one reported anti-tumor efficacy and toxicity; the other reported economic data.…”

Section: Resultsmentioning

confidence: 99%

Pazopanib has equivalent anti-tumor effectiveness and lower Total costs than Sunitinib for treating metastatic or advanced renal cell carcinoma: a meta-analysis

et al. 2019

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Background Sunitinib and pazopanib are extensively used as first-line treatment of metastatic renal cell carcinoma (mRCC). We performed this meta-analysis to assess the anti-tumor effectiveness, toxicity, and total costs of the two drugs among patients with mRCC/advanced RCC (aRCC). Materials and Methods: PubMed, ScienceDirect, Scopus, Web of Science, Ovid MEDLINE, the Cochrane Library, Embase, and Google Scholar were searched to obtain eligible articles. The endpoints included progression-free survival (PFS), overall survival (OS), adverse effects (AEs), and per-patient-per-month (PPPM) costs. Results We included 14 medium- to high-quality studies. Both drugs were valid for mRCC/aRCC, with equivalent PFS (hazard ratio (HR) =1.06, 95% confidence interval [CI]: 0.98–1.15, P = 0.13), OS (HR = 0.92, 95% CI: 0.79–1.07, P = 0.29), objective response rate (ORR, risk ratio (RR) =1.03, 95% CI: 0.93–1.13, p = 0.58), and disease control rate (DCR, RR = 1.03, 95% CI: 0.94–1.22, P = 0.54). Sunitinib had more dosage reductions and higher PPPM (weighted mean difference = − 1.50 thousand US dollars, 95% CI: − 2.27 to − 0.72, P = 0.0002). Furthermore, more incidences of severe fatigue, thrombocytopenia, and neutropenia were recorded for sunitinib, but pazopanib had more liver toxicity. In subgroup analysis, studies from the US reported longer OS (HR = 0.86, 95% CI: 0.77–0.95, P = 0.004) and higher ORR (RR = 1.24, 95% CI: 1.03–1.51, P = 0.03). Conclusions Pazopanib provides equivalent anti-tumor effectiveness and lower PPPM as compared with sunitinib for mRCC/aRCC. Great care should be given to pazopanib-treated patients with abnormal liver function. Nevertheless, more large-scale, high-quality studies are required. Electronic supplementary material The online version of this article (10.1186/s12885-019-5704-3) contains supplementary material, which is available to authorized users.

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Persistence and Compliance Among U.S. Patients Receiving Pazopanib or Sunitinib as First-Line Therapy for Advanced Renal Cell Carcinoma: A Retrospective Claims Analysis

Cited by 17 publications

References 34 publications

Sunitinib in Metastatic Renal Cell Carcinoma: A Systematic Review of UK Real World Data

Sunitinib in Metastatic Renal Cell Carcinoma: A Systematic Review of UK Real World Data

Pazopanib in the treatment of advanced renal cell carcinoma

Pazopanib has equivalent anti-tumor effectiveness and lower Total costs than Sunitinib for treating metastatic or advanced renal cell carcinoma: a meta-analysis

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